Global Burden of Cardiovascular Diseases

In recent years, the dominance of chronic diseases as major contributors to total global mortality has emerged and has been previously described in detail elsewhere. By 2005, the total number of cardiovascular disease (CVD) deaths (mainly coronary heart disease, stroke, and rheumatic heart disease) had increased globally to 17.5 million from 14.4 million in 1990. Of these, 7.6 million were attributed to coronary heart disease and 5.7 million to stroke. More than 80 percent of the deaths occurred in low and middle income countries (WHO, 2009e).

Based on 2007 to 2010 data, 33% of US adults ≥ 20 years of age have hypertension. This represents ~ 78 million US adults with hypertension. The prevalence of hypertension is similar for men and women. African American adults have among the highest prevalence of hypertension (44%) in the world.

New research offers reassurance over multiple artery procedures for heart attack victims

Dec 17, 2015 Viewed: 478

A new study has examined the effects on the heart of treating multiple narrowed arteries - rather than just one - at the time of a heart attack.

Specialist heart doctors increasingly treat patients with large heart attacks urgently with a procedure under local anaesthetic. The blocked blood vessel (artery), which causes the heart attack is opened by inserting a small metal scaffold (stent) at the blockage to hold the artery open.

Now a study led by Dr Gerry McCann, NIHR Career Development Fellow from the University of Leicester and Leicester’s Hospitals, has examined whether treating more than one artery has an adverse effect on the heart.

Dr McCann said: “Up to 50% of patients treated for a blocked artery also have other narrowed, but not totally blocked, heart arteries. Two recent studies in patients with heart attacks and multiple narrowed arteries have suggested that treating all of the narrowed arteries may be better than just treating the blocked artery.

“However, there is concern that the longer procedure, and putting in more stents, may cause more damage to the heart.”

The researchers studied 203 patients having a heart attack who were randomly assigned to have only the blocked artery (105 patients) or all the narrowings treated (98 patients) in seven hospitals in England.

Dr McCann said: “We assessed the amount of heart muscle damage that occurred with MRI scans. Patients who had all the heart arteries treated had more than one area of heart muscle damage more frequently (22% v 11%) than those who just had the blocked artery treated. However, the percentage of the heart that was damaged was not increased (12.6% v 13.5%) and the heart function early and nine months afterwards was similar with both treatments.

“The results of this study provide reassurance that specialists treating patients with a heart attack can open more than one narrowed artery without increasing the total amount of heart damage.”

Professor Peter Weissberg, Medical Director at the British Heart Foundation, which helped fund the study, said: “In the process of identifying and opening, by using a stent, the blocked artery causing a heart attack, the cardiologist may discover other narrowed arteries. There has been much debate as to whether the cardiologist should stent these additional narrowings at the same time.

“This study suggests that it is safe for the cardiologist to insert a stent into all narrowings they discover while treating a heart attack. However, cardiologists must make a judgement at the time as to whether an artery is narrowed enough to warrant insertion of a stent.

“From the patient’s perspective it is essential that he or she calls 999 at the first signs of a heart attack - most commonly discomfort in the chest so that they can be swiftly assessed and treated. The blocked artery causing a heart attack must be cleared as soon as possible.”

###

Dr McCann is Reader at the University of Leicester and Honorary Consultant Cardiologist at Glenfield Hospital. This research is published in JACC, the Journal of the American College of Cardiology. The work was funded by the Efficacy and Mechanism Evaluation Programme, an MRC and NIHR partnership. It is a sub study of the CvLPRIt trial that was also led by Leicester Professor Tony Gershlick and funded by the British Heart Foundation.

It's easy to make a financial decision based on what you need right now, but making an informed choice will benefit you in the long run. Meet a former Red Sox pitcher who picked security over an uncertain future